• Home
• Advice
• New! FREE Webinars
• Products
• Courses
• Online CE
• Videos

>>Advertise

Mandibular Bar Overdenture

posted in Treatment Planning & Complications

« Fosamax Linked to Jaw Disease | Waiting Period After Bone Grafting? »

Print This Post

Dr. Larson asks:

I have just inherited a new patient with a mandibular bar overdenture supported by 2 dental implants in the #22, 27 areas. The bar is slightly curved so that the 2 Hader clips are each slightly canted to the right and left.

I
think the arc of rotation of the overdenture is limited because these
clips
are not parallel and are not perpendicular to the midsagittal plane of
the
overdenture.  The dental implants are 15 years old and the bone level is down
to
the third thread. 

Several weeks ago the patient reported that she had
pain,
swelling and drainage around the dental implants, but is asymptomatic now.  The
pocket health now is comparable to a healthy dental implant.  In terms of
prognosis
or intervention, should I do anything different? Thanks for any comments and suggestions.

2 Responses to “ Mandibular Bar Overdenture ”

• Robert J. Miller June 6th, 2006

  
  

  While the rotation of Hadar clips should ideally be perpendicular to the axis of rotation, it is doubtful that after 15 years of function that the curve of the bar is a major factor in this problem. Bone loss to the third thread is a common finding in implants of that era as well. Maintenance and changes in systemic health are a more likely cause. If this site becomes active again, consider using a laser to debride the area. It will remove calculus, result in a high bacterial kill, and, dependent on wavelength, provide some biostimulation as well.

• Jim Ellison June 8th, 2006

  
  

  Although we seldom see a curved Hader Bar today, it was more popular 15 to 20 years ago. A slight curve will not hinder the retention of the two clips, but you are correct, a straight bar would have allowed more rotation. But, I agree with Robert Miller, maintenance and/or some health issues are more likely the cause of the problem you describe.

  In addition to his suggestion, another way of making it easier for the patient to maintain is to remove the bar and substitute a free-standing abutment. Obviously, these abutments would be easier to clean around, but there are some other advantages. A study done at UCLA suggested that the free-standing ERA abutments did a better job of more evenly distributing occlusal load than two styles of Hader Bar retention. A comparison study done by Dr. Vicki Petropoulos of U.Penn showed that the ERA allowed less force distribution to the implants than any other type of attachment that was included in the study. This did include bars, but it also included some free-standing abutments, like ball-and o-rings and ZAAGs. Therefore, if you think that you would like to have less force directed to these implants and make it easier for the patient to maintain them, you might consider switching to free-standing abutments, like the ERA.

---

Leave a Comment

Comment Guidelines: This is a forum for dentists for intelligent discussion. No insults. No outside links. No promotional comments. Though we require an email to route questionable comments to our editors, we will NEVER publish your email. Consumers & Patients: Please do NOT post dental questions here. Instead Visit ChooseDentalImplants.com to get Expert Advice for Implants.

Name (required)

Email (Required, Will NEVER be published)

Website

Message:

Note: At times your comment may not appear on the website immediately, because it has been sent to our editors for approval. Once approved, we will publish the comment. There is NO need to resubmit your comment, if it does not appear on the website immediately.